Exertional dyspnea

Patients can experience a variety of symptoms related to buildup of fluid in the lungs. Dyspnea, or shortness of breath, can result from pulmonary congestion or systemic hypoperfusion due to LVF. Exertional dyspnea occurs when patients describe breathlessness induced by physical activity or a lower level of activity than previously known to cause breathlessness. Patients often state that activities such as stair climbing, carrying groceries, or walking a particular distance cause shortness of breath. Severity of HF is inversely proportional to the amount of activity required to produce dyspnea. In severe HF, dyspnea will be present even at rest. 

Anxiety, exertional dyspnea, weakness, fatigue, dizziness, lethargy, headache, syncope, tachycardia... 

Iron deficiency is the most common cause of chronic anemia. Like other forms of chronic anemia, iron deficiency anemia leads to pallor, fatigue, dizziness, exertional dyspnea, and other generalized symptoms of tissue hypoxia. The cardiovascular adaptations to chronic anemia—tachycardia, increased cardiac output, vasodilation—can worsen the condition of patients with underlying cardiovascular disease. 

Mild headache, exertional dyspnea, cutaneous vasodilation... 

A dental laboratory technician developed progressive exertional dyspnea and cough associated with pulmonary granulomatosis. Lung function studies showed a restrictive pattern with a low diffusion capacity. A high-resolution CT scan showed micronodules in both... 

A 29-year-old woman with ulcerative cohtis taking mesalazine 1 g tds developed respiratory distress (40). Her respiratory symptoms (chest pain and respiratory distress, especially exertional dyspnea) occurred 48 hours after she started to take mesalazine and disappeared immediately on withdrawal. Similar sjmptoms recurred on rechallenge 3 weeks later in a lower dose of 500 mg bd. Chest X-ray and white cell count a day later were normal. 

In a retrospective review of 70 patients with hepatitis C enrolled in four clinical trials, there were four cases of significant pulmonary toxicity (two of bronchiolitis obliterans and two of interstitial pneumonitis) (45). Three recovered completely, but one still required glucocorticoids for exertional dyspnea that persisted 17 months after interferon alfa withdrawal. The authors suggested that there was an increased risk with high-dose interferon, because three of these patients received high doses (5 MU/day) or pegylated interferon alfa. In contrast, they were unaware of any significant pulmonary... 

Pulmonary congestion arises as the left ventricle fails and is unable to accept and eject the increased blood volume that is delivered to it. Consequently, pulmonary venous and capillary pressures rise, leading to interstitial and bronchial edema, increased airways resistance, and dyspnea. The associated signs and symptoms may include (1) dyspnea (with or without exertion), (2) orthopnea, (3) paroxysmal nocturnal dyspnea (PND), and (4) pulmonary edema. Exertional dyspnea occurs when there is a reduction in the level of exertion that causes breathlessness. This is typically described as more breathlessness than was associated previously with a specific activity (e.g., vacuuming or stair climbing). As heart failure progresses, many patients eventually have dyspnea at rest. 

Patients with pulmonary hypertension often complain of exertional dyspnea, chest pain, and syncope. Due to the nonspecific nature of these symptoms and lack of a noninvasive diagnostic test for detecting pulmonary hypertension, there are often delays in the... 

As with any anemia, cardiovascular abnormalities, including cardiac enlargement and various murmurs, can occur in patients with SCD. Patients complain of various degrees of exertional dyspnea, tachycardia, and palpitation owing to the decreased oxygen-carrying... 

Summary A 48-year-old male with strong family history of heart disease and now angina and exertional dyspnea presents with a significantly elevated cholesterol level. A medication is prescribed that is directed at the rate-limiting step of cholesterol biosynthesis. 

The majority of patients with pulmonary hypertension are largely asymptomatic until marked vascular alterations have developed. When blood flow through the pulmonary artery is obstructed over a long period of time, however, the clinical picture is predictable and markedly uniform. In general, the patients exhibit normal pulmonary function measurements, a low carbon monoxide diffusion capacity (DlCO), and marked hyperventilation that leads to hypocapnia and decreased serum bicarbonate concentrations. Additional symptoms include weakness, fatigue, exertional dyspnea, and chest pains upon exertion due to low cardiac output and hypoxemia. Occasionally, hoarseness, hemoptysis, and cyanosis occur. 

CHRONIC HEALTH RISKS chronic eye irritation nose ulcers allergic skin rashes increased wheezing shortness of breath cough with sputum cough with phlegm increased incidence of bronchitis chronic conjunctivitis expectoration exertional dyspnea x-ray changes of the lungs respiratory impairment impaired pulmonary function dermatitis of hands, forearms, and feet eczematous lesions with vesicles, erythema and fissures. 

All nine patients were admitted to the hospital with a generally nonproductive cough. Onset of respiratory symptoms was 10.4 5.4 hours, and duration was 92 41 hours. Five of the nine patients had inspiratory rales with dyspnea. The three most seriously compromised patients had dyspnea, moist inspiratory and expiratory rales, and orthopnea these signs gradually cleared. One of these three patients had profound dyspnea for the first 12 hours, which moderated to exertional dyspnea and rales that persisted for 10 days. 

D Symptomatic severe AS >4m/s <1 cm >40 mmHg <50% Severe calcification and severely reduced leaflet opening Exertional dyspnea, exertional angina and syncope of angina... 

A man who took rimonabant for 5 weeks developed palpitation, fatigue, and exertional dyspnea. He had atrial fibrillation with a ventricular rate of 98-135/minute. No other cause of atrial fibrillation was found and rimonabant was withdrawn. After 2 weeks his rhythm had reverted to sinus rhythm. The patient refused re-challenge and 9 months later was still in sinus rhythm. 

After taking rimonabant for 3 weeks a man developed dizziness, palpitation, and exertional dyspnea. He had atrial fibrillation, for which no other causes were found. Rimonabant was withdrawn and 10 days later the rhythm had reverted to sinus rhythm with first-degree atrioventricular block. 

Respiratory Three cases of interstitial pneumonia have been described in Japanese patients during treatment with bepridil. In one case, exertional dyspnea developed over 8 months and transbronchial lung biopsy specimens showed moderate lymphocytic infiltration glucocorticoid therapy led to resolution in 3 weeks [48 ]. The other two patients developed pneumonia after 20 and 60 days one required glucocorticoid treatment and the other was discharged having improved after bepridil withdrawal [49 ]. 

A 23-year-old man with ulcerative proctitis was treated successfully with topical mesalazine and beclometasone dipropionate [94 ]. After 1 month the treatment was stopped, but 5 years later, a relapse was treated with topical mesalazine and then oral mesalazine 2.4 g/day. After 3 days the patient developed pleuritic chest pain, exertional dyspnea, fever (38°C), and arthralgias, in particular in the shoulders and spine. Chest X-ray showed a right-sided basal pleural effusion. He was given intramuscular ceftriaxone 1 g/day and oral methylprednisolone 16 mg/day and after 11 days the chest symptoms resolv 1 month later mesalazine and glucocorticoid treatment were withdrawn, but 1 month later a relapse was treated again with oral mesalazine 2.4 g/ day. After 3 days the same pleuritic symptoms occurred and disappeared promptly on withdrawal of mesalazine. 

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